Revista médica de Chile
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Revista médica de Chile · Sep 2018
[Entrustable professional activities: a new proposal for the evaluation of the medical competencies].
Medical education migrated from a practice-based to a knowledge-based discipline after the publication of the Flexner Report. The emergence of competence-based medical education led to a greater standardization of teaching, allowing students to integrate knowledge, skills and attitudes for the execution of a given task. A challenge is the evaluation of learning. ⋯ Supervisors observe students' performance and decide if the apprentice can execute a specific task independently. This decision is based upon the trust that the tutor places on the student. Consequently, Ten Cate (2005) proposed the term Entrustable Professional Activities (EPAs), as a framework for professional practice tasks or responsibilities that can be fully entrusted to students, when they demonstrate the competences that are necessary to execute such activity with an increasing level of autonomy.
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The risk of sudden unexpected death in patients with epilepsy (SUDEP), is 20 to 25 times greater than in the general population. This increased risk is seen specially in refractory epilepsy, with an incidence of 9:1,000 patients-years. Risk factors have been established based on retrospective studies, finding that the frequency of seizures, specially generalized tonic clonic seizures, is the most important one. ⋯ Autonomic system abnormalities, as well as cardiac and respiratory changes have been found. The finding of new molecular biomarkers to identify patients with increased risk should be a priority. Treatment is based in the management of risk factors, although clear recommendations are hard to establish given the low level of evidence.
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Revista médica de Chile · Jul 2018
Review[Translational medicine and innovation in health: mechanisms and perspectives].
Many new discoveries in Life Sciences cannot be translated into products, services or new applications to improve human health. Translational medicine, defined as "from bench to bedside", refers to the transfer of results or new knowledge achieved in the laboratory into health innovation. We aim to review the state of art of translational medicine, its relationship with innovation processes and the different perspectives to consider. Finally, we contextualize the situation of Research and Development (R&D) in Chile and the main issues of the biotechnology market in the country.
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Revista médica de Chile · Jun 2018
[Emergency endovascular management of ischemic stroke. Experience in 104 patients].
Recently, five randomized controlled trials confirmed the efficacy and safety of endovascular treatment with or without intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. ⋯ The clinical improvement of these patients 24 hours after the procedure and at discharge demonstrate the effectiveness of endovascular treatment in ischemic stroke. The presence neurologists able to interpret multimodal images at the emergency room, the use of local guidelines, the availability of an experienced neuro-interventional team engaged with the workflow and the use of stent retrievers are strongly associated with good outcomes.
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Revista médica de Chile · Jun 2018
[Verbal and physical abuse towards health care workers in emergency services].
One of the peculiarities of our society is the increase in violence and its repercussions in various areas. Health care is not an exemption. ⋯ There is a high prevalence of verbal abuse and physical violence in emergency services, which requires measures to achieve a zero tolerance to violence in these spaces.